WASHINGTON — The Nebraska Farm Bureau’s chief administrator recalls the emotional health-related stories that poured out when the organization held a series of listening sessions across the state last summer.

“Literally they got up in tears talking about their challenges of how they’re coping with the health insurance markets,” Rob Robertson said.

Those farmers and ranchers talked about having to give up health insurance altogether or being forced to work off the farm because of high premiums — typically the biggest living expense on the farm, he said.

Robertson testified Tuesday at a House Ways and Means Committee hearing focused on protecting individuals with pre-existing health conditions.

Republicans and Democrats on the committee sparred throughout about the Affordable Care Act, which established robust protections for people with pre-existing conditions.

Democrats brought up the dozens of times that Republicans have voted over the years to repeal the ACA, while Republicans responded that their most recent proposals included language explicitly guaranteeing that protections for pre-existing conditions would continue.

Experts say while that GOP legislation did include statements guaranteeing pre-existing conditions coverage, those protections would have been weaker in some ways. For example, higher premiums could have been charged for those with pre-existing conditions who failed to maintain continuous coverage.

The choice of topic for Tuesday’s hearing reflected how newly empowered Democrats continue to emphasize health care policy, an area that helped win them back control of the House in the midterm elections.

Robertson was invited to talk about the Farm Bureau’s own insurance offerings. About 700 members have signed up for the coverage through the farm group’s partner Medica, with premiums about 25 percent less than the state’s ACA marketplace.

“We strongly support the continuation of health plans that cover pre-existing conditions,” Robertson testified. “The key is to provide innovative policy solutions to allow for those type of things like the association health plans to be a part of how we cover pre-existing conditions. Hopefully our plan works.”

The Farm Bureau says its dramatic savings come from having customers rated as a large group plan rather than as individuals. Creating such a pool also cuts down on administrative costs and helps share the risk, Robertson said.

Karen Pollitz, a senior fellow at the Kaiser Family Foundation, which studies health care and insurance, also testified at Tuesday’s hearing. She warned that a number of Trump administration actions have injected uncertainty into the health insurance markets, such as fostering skimpy, short-term plans that undermine the broader ACA marketplaces.

The Nebraska Farm Bureau plans aren’t on par with those short-term plans — they are ACA-compliant. But Pollitz told The World-Herald that they still differ from ACA plans in important respects.

While plans on the exchange have to rate their products for the average person across the state, the Farm Bureau insurance has to deal only with the specific group signing up.

And just pooling people together on its own isn’t going to be a magic bullet for reducing costs, she said.

Rep. Adrian Smith, R-Neb., a senior member of the committee, said the hearing shows broad agreement on the concept of protecting people with pre-existing conditions. But he also said he’s concerned to see such high premiums today.

“Many Nebraskans have been harmed by the heavy hand of the federal government,” Smith said.

Rep. Mike Thompson, D-Calif., thanked Robertson for his testimony but emphasized that the insurance the group is offering is ACA-compliant.

“That’s an important factor, because if it weren’t for that, it could very easily be another junk policy that takes your members’ premiums and they’re there for you every step of the way, unless you become injured or you become ill,” Thompson said. “It was the ACA that provided that protection.”